PDF(Pubmed)
Abstract：
BACKGROUND: Mental illnesses are common among children and negatively impact wellbeing during childhood as well as later in life. However, many children with these conditions are not able to access needed mental health care. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) was created to reduce gaps in access to care by providing primary care providers with referral resources, access to behavioral health consultations, and training on mental health topics.
OBJECTIVE: The purpose of this study was 1) to assess the effectiveness of the WI CPCP in Milwaukee County, providing specific insights into provider\'s ability to care for child mental health, and 2) identify challenges Milwaukee PCPs faced in providing mental health care to child patients and contextualize these challenges in a conceptual framework of access to health care.
METHODS: A cross-sectional mixed-methods secondary data analysis was conducted using data collected from online baseline and nine-month follow-up surveys completed by providers participating in the program practicing in Milwaukee County from 2014 to 2022. Provider confidence and skill in providing mental health care was analyzed quantitatively using Two-sample Wilcoxon rank-sum (Mann-Whitney) tests (baseline vs. follow-up survey responses) and descriptive statistics (follow-up survey only). Provider challenges to providing mental health care were analyzed qualitatively using a thematic analysis research approach.
RESULTS: Results from quantitative analyses showed that provider confidence and skill in treating childhood anxiety and depression improved from baseline to follow-up. Results from qualitative analyses were categorized by factors within and beyond the scope of WI CPCP. Within the scope of WI CPCP, providers reported a lack of knowledge of referral options and a lack of training in mental health care as well as a lack of knowledge in assessing and treating mental disorders. Still, many barriers to mental healthcare access persist that are beyond the scope of WI CPCP, such as long wait times and a lack of insurance coverage.
CONCLUSIONS: This study supports the effectiveness of the program to improve access to care for children. However, there is a need for additional solutions such as better reimbursement for mental health professionals and expanded insurance coverage.
OBJECTIVE: The purpose of this study was 1) to assess the effectiveness of the WI CPCP in Milwaukee County, providing specific insights into provider\'s ability to care for child mental health, and 2) identify challenges Milwaukee PCPs faced in providing mental health care to child patients and contextualize these challenges in a conceptual framework of access to health care.
METHODS: A cross-sectional mixed-methods secondary data analysis was conducted using data collected from online baseline and nine-month follow-up surveys completed by providers participating in the program practicing in Milwaukee County from 2014 to 2022. Provider confidence and skill in providing mental health care was analyzed quantitatively using Two-sample Wilcoxon rank-sum (Mann-Whitney) tests (baseline vs. follow-up survey responses) and descriptive statistics (follow-up survey only). Provider challenges to providing mental health care were analyzed qualitatively using a thematic analysis research approach.
RESULTS: Results from quantitative analyses showed that provider confidence and skill in treating childhood anxiety and depression improved from baseline to follow-up. Results from qualitative analyses were categorized by factors within and beyond the scope of WI CPCP. Within the scope of WI CPCP, providers reported a lack of knowledge of referral options and a lack of training in mental health care as well as a lack of knowledge in assessing and treating mental disorders. Still, many barriers to mental healthcare access persist that are beyond the scope of WI CPCP, such as long wait times and a lack of insurance coverage.
CONCLUSIONS: This study supports the effectiveness of the program to improve access to care for children. However, there is a need for additional solutions such as better reimbursement for mental health professionals and expanded insurance coverage.
摘要：
背景：精神疾病在儿童中很常见，对儿童和以后生活的健康产生负面影响。然而,许多患有这些疾病的儿童无法获得所需的精神保健。威斯康星州儿童精神病学咨询计划（WICPCP）旨在通过向初级保健提供者提供转诊资源来减少获得护理的差距，获得行为健康咨询，和心理健康主题培训。
目的：本研究的目的是1）评估密尔沃基县WICPCP的有效性，提供对提供者照顾儿童心理健康的能力的具体见解，and2)identifychallengesMilwaukeePCPfacedinprovidingmentalhealthcaretochildpatientsandcontactualizethesechallengesinaconceptualframeworkofaccesstohealthcare.
方法：使用从2014年至2022年在密尔沃基县参与该计划的提供者完成的在线基线和9个月随访调查中收集的数据进行了横断面混合方法二次数据分析。使用双样本Wilcoxon秩和（Mann-Whitney）检验（基线与后续调查回复)和描述性统计(仅限后续调查)。使用主题分析研究方法对提供者提供精神卫生保健的挑战进行了定性分析。
结果：定量分析结果表明，从基线到随访，提供者在治疗儿童焦虑和抑郁方面的信心和技能得到了改善。定性分析的结果按WICPCP范围内外的因素进行分类。在WICPCP的范围内，提供者报告缺乏转诊选择的知识，缺乏精神保健方面的培训，以及缺乏评估和治疗精神障碍的知识。尽管如此，许多障碍仍然存在，超出了WICPCP的范围，例如漫长的等待时间和缺乏保险。
结论：这项研究支持改善儿童获得护理的计划的有效性。然而,需要其他解决方案，例如为精神卫生专业人员提供更好的报销和扩大保险范围。
目的：本研究的目的是1）评估密尔沃基县WICPCP的有效性，提供对提供者照顾儿童心理健康的能力的具体见解，and2)identifychallengesMilwaukeePCPfacedinprovidingmentalhealthcaretochildpatientsandcontactualizethesechallengesinaconceptualframeworkofaccesstohealthcare.
方法：使用从2014年至2022年在密尔沃基县参与该计划的提供者完成的在线基线和9个月随访调查中收集的数据进行了横断面混合方法二次数据分析。使用双样本Wilcoxon秩和（Mann-Whitney）检验（基线与后续调查回复)和描述性统计(仅限后续调查)。使用主题分析研究方法对提供者提供精神卫生保健的挑战进行了定性分析。
结果：定量分析结果表明，从基线到随访，提供者在治疗儿童焦虑和抑郁方面的信心和技能得到了改善。定性分析的结果按WICPCP范围内外的因素进行分类。在WICPCP的范围内，提供者报告缺乏转诊选择的知识，缺乏精神保健方面的培训，以及缺乏评估和治疗精神障碍的知识。尽管如此，许多障碍仍然存在，超出了WICPCP的范围，例如漫长的等待时间和缺乏保险。
结论：这项研究支持改善儿童获得护理的计划的有效性。然而,需要其他解决方案，例如为精神卫生专业人员提供更好的报销和扩大保险范围。
